Fatal attraction: How do we talk to our sons about sex and cancer?

MICHAEL Douglas may have retracted his claim about what caused his throat cancer, but – as the mother of two red-blooded sons aged 18 and 21 – the story still triggered anxieties about the link between oral sex and this type of cancer in men.

MICHAEL Douglas may have retracted his claim about what caused his throat cancer, but – as the mother of two red-blooded sons aged 18 and 21 – the story still triggered anxieties about the link between oral sex and this type of cancer in men.

Neither I nor their father have the least idea how to approach the topic with them. Even if we summoned the courage to do so, we are unsure what we would advise.

Our sons are well-informed about the importance of safe sex, thanks to their savvy teachers rather than their tongue-tied parents. But I doubt whether even their forward-looking schools would have covered the potential risk of throat cancer from the human papillomavirus (HPV).

To recap: about 15 types of HPV are linked with the risk of cancer. Disturbingly, of the 6,000 throat cancers diagnosed annually, between 25 and 35pc are thought to be HPV-related, and are most commonly found in heterosexual men in their forties and fifties.

Is more frequent oral sex to blame? The health service points out that the practice (cunnilingus, especially) is often a conduit for sexual infections and is likely to be responsible for HPV transmission to the mouth and throat.

So why aren't boys offered Gardasil, the vaccine that protects against two strains of HPV linked to 75 per cent of cervical cancers, and which studies suggest can protect against other HPV-linked cancers, too? Australian authorities began offering shots to schoolboys earlier this year, and many experts are calling for a similar move in the UK. But the thinking seems to be that, once most young women have acquired immunity, their male partners will do so, too. Cost is another factor.

I'm not sure just how sexually active my sons have been, or are. The elder is now in a serious relationship; the younger one is, I suspect, on the verge of sexual discovery.

Private HPV vaccinations for boys are available; although Gardasil is only licensed for boys aged 9-15, it can be prescribed outside this range "at the doctor's discretion", according to one clinic. But how do you approach a young man who has just fallen in love for the first time and suggest that he be vaccinated against an infection he might "catch" from his beloved during certain sexual practices?

Maybe we have been too queasy about raising this issue with our children – or maybe we are too anxious, given that the risk of getting throat cancer from oral sex is probably very small, compared with the risk from tobacco and alcohol. Clearly we can't get young adults to swear off oral sex, though we might send them useful government advice on preventing infections via this route.

One thing we won't be doing is passing on Douglas' nonsensical advice – that oral sex is also the "best cure" for throat cancer. It may have been a joke, but what was he thinking of?